Legionnaires’ Disease and Use of Tumor Necrosis Factor-Αlpha Inhibitors: A Forthcoming Problem?


  • Zorica Nanovic Institute of Lung Diseases and Tuberculosis, Vodnjanska 17, Skopje 1109
  • Milena Petrovska Institute of Microbiology and Parasitology, Medical Faculty, University Ss Cyril and Methodius of Skopje




opportunistic infection, Legionnaires’ disease, TNF-α inhibitors, immunosuppresion, rheumatic diseases.


Aim: To establish a review in the current literature and to analyze the relation Legionnaires’ disease – TNF-α inhibitors, in order to estimate the real indications for such connection.

Material and Methods: The electronic data for PubMed and Google Scholar have been searched, according to the vocabulary: legionellosis, epidemiology, outbreak, diagnosis, pathogenesis, therapy, TNF-α inhibitors, indications, side effects, risk of infection. The obtained studies have been selected in English, according to the relevance by the topic.

Results: Selected papers, consisted of ten studies and eight case reports, yielded 35 cases of Legionnaires' disease associated with the use of TNF- α inhibitor treatment.

Discussion: There is a prevailing conclusion for increased risk of serious infections while using TNF-α inhibitors and also a deficiency of studies for an association of Legionnaires’ disease with the use of TNF-α inhibitors. Sub-diagnosing and no-existence of screening before the anti-TNF-α therapy blur the factual profile for the researched relation. The possibility for latent infection has not been sufficiently researched.

Conclusion: There are indications that Legionnaires’ disease in the therapy with TNF-α inhibitors is indeed a forthcoming problem. Additional target researches are required in order to establish the position of Legionnaires’ disease in the mosaic of anti - TNF-α therapy.


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How to Cite

Nanovic Z, Petrovska M. Legionnaires’ Disease and Use of Tumor Necrosis Factor-Αlpha Inhibitors: A Forthcoming Problem?. Open Access Maced J Med Sci [Internet]. 2013 Dec. 15 [cited 2021 Apr. 12];1(1):127-34. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2013.025



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